stomach

Role Of PET Scan in CA Stomach

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Q) What is not true about the role of PET Scan in staging of Ca Stomach?

a) 50% of Carcinoma stomach are PET avid

b) Response to Neoadjuvant therapy is  usually seen on PET in 2 weeks

c) PET response correlates with survival 

d) Sensitivity of PET is same for all kinds of histopath tumors

Highly selective vagotomy

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Q) False about highly selective vagotomy? ( # Gastric Surgery MCQS)  (# Questions on Esophagus) 
a) Highly selective vagotomy divides the vagus nerves supplying the acid-producing portion of the stomach
b) Incidence of postoperative complications is lower.
c) The criminal nerve of Grassi should be severed

d) Crow's feet nerves are severed till below the GE junction

This Question discusses the concept of criminal nerve of Grassi and features of HSV

Ans -d

Highly Selective Vagotomy (HSV)  only divides the last part of the nerves which supply the part of stomach which produces acid.
Anterior  and posterior  nerves of Latarjet are found and their terminal branches are severed from 7 cm proximal to the pylorus to 5 cm above the GE junction
Motor function of the stomach is not affected
Criminal nerve of Grassi is branch of posterior Vagus. It should be sought and cut. This nerve derives its name from the common mistake done during vagotomy. This nerve is often missed and responsible for recurrence of symptoms of Peptic ulcer disease.

 

Criminal Nerve of Grassi is 1st branch of posterior vagus
Criminal Nerve of Grassi is from posterior vagus
MOre 

Vagus Nerve branches 

  • Anterior trunk: Gives
Branch to liver GB and Bile duct and goes along the lesser curvature as the anterior nerve of Latarjet

  • Posterior Trunk:

    Sends branches to the celiac plexus and continues along the posterior aspect of the lesser curvature as the posterior nerve of Latarjet.
    • Criminal Nerve of Grassi: The first branch of the posterior trunk, innervates the gastric fundus. Failure to divide this nerve during an acid-reducing surgery can lead to recurrent ulcers
    • Crows Foot: The most distal branches of the anterior and posterior trunks and provides innervation to the antro-pyloric region. These branches are spared in a highly selective vagotomy (HSV)
    • Parasympathetics are vagally mediated using acetylcholine as the primary neurotransmitter

Question on Dumping Syndrome

Acute Gastric dilatation

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Q) Not true about acute gastric dilatation (AGD) 

a) AGD is encountered most often as a postoperative complication in abdominal surgery 

b)Also seen in other  disorders, such as anorexia and bulimia nervosa, psychogenic polyphagia, trauma, diabetes mellitus 

c) When intragastric pressure from gastric distension exceeds 20 cm H2O gastric necrosis starts

d)  Clinical features are pain abdomen and effortless vomiting

 

Gastric lymphoma

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Q ) Treatment of Primary Gastric Lymphoma is 

a) Surgery

b) chemotherapy

c) Radiotherapy

d) Both chemo and radiotherapy

Stomach Physiology

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Q) Regarding the microscopic anatomy of stomach, false statement is ?

a) Parietal cells are abundant in the body of stomach and secrete H+

b) Chief cells produce pepsinogen I and II

c) G cells are abundant in gastric antrum

d) ECL cells are abundant in antrum 

Ans visible for premium members

 

Delayed complications of loop gastrojejunostomy

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Q) Most common delayed complication of loop gastrojejunostomy

a) anemia

b)) gastric reflux

c) stricture

d) malignancy

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Right gastroepiploic vein

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Q) Right gastroepiploic vein drains into
A. Splenic vein
B. Left gastric vein
C. Portal vein
D. Superior mesenteric vein

ANswer is free

D

SMV

Veins of SMV
Right gastro epiploic vein

The right gastroepiploic vein is a significant blood vessel located in the abdomen. It runs parallel to the right gastroepiploic artery and is an essential part of the venous drainage system of the stomach.

Originating from the greater curvature of the stomach, this vein receives blood from various branches, including the short gastric veins. As it continues its course, it eventually joins with the superior mesenteric vein, contributing to the portal venous system. Understanding the anatomy and function of the right gastroepiploic vein is crucial for medical professionals in diagnosing and treating related conditions, ensuring proper circulation and overall digestive health.

The right gastroepiploic vein is essential in many surgical procedures:

  • Gastric Bypass and Gastric Cancer Surgery: The RGEV may require ligation or resection in gastrectomy procedures. Surgeons should be cautious of potential bleeding risks and the implications for vascular flow.
  • Coronary Artery Bypass Grafting (CABG): Surgeons often use the right gastroepiploic artery as a graft, though the associated vein is also considered during CABG preparation due to its proximity and importance.
  • Trauma and Emergency Surgery: Understanding Right gastroepiploic vein anatomy aids in identifying bleeding sources, especially in abdominal injuries.

Questions on Liver 

Surgery Anatomy

Malabsorbtive procedure in bariatric Surgery

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Q) Malabsorbtive  procedure in bariatric Surgery

a) Biliopancreatic division

b) Roux en Y Gastric bypass

c) Sleeve gastrectomy

d) LAp band

Answer 

 

 

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